Óleos de peixe e aterosclerose
Palavras-chave:
óleos de peixe, ácidos gordos omega 3, ácido eicosapentanóico, ateroscleroseResumo
Estudos epidemiológicos demonstram uma signi ficativa correlação inversa entre o consumo de peixe e a doença aterosclerótica. Fracção importante dos óleos de peixe, os ácidos gordos omega 3, par ticularnente o ácido eicosapentanóico, parecem ser os mediadores dessa acção, que seria consequên cia de vários efeitos metabólicos, nomeadamente:
1) actividade hipolipemiante, diminuindo a síntese de triglicerídeos; 2) antiagregante plaquetar, devido à síntese de tromboxano A3 em detrimento do A2; 3) anti-inflamatória, pela diminuição da síntese de leucotrieno B4, um potente agente quimiotático de neutrófilos e monócitos, e aumento da síntese de leucotrieno B5; 4) antitrombótica, reduzindo os níveis de PAI-1 efibrinogénio; 5) melhoria da per fusão dos tecidos. O consumo de concentrados de óleos de peixe parece ser praticamente inócuo, com a hipotética excepção dos diabéticos, na medida em que poderá piorar o controlo glicémico.
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Bang H O Coronary heart disease and Q-3: epidemiological aspects Em: Fish oil and blood-vessel wall interactions, Eds. PM Vanhouttc, Ph Douste-Blazy.John Libbey Eurotext, Paris 1991; PP 109-116.
Israel DH, Gorlin R Fish oils in the prevention of atherosclerosis. J Am Coll Cardiol 1992; 19: 174-185.
Burr ML Fish anel ischaemic hearl eliseasc Em: Nutrition and fitness in health anel disease, Simopoulos AP (eel.), World Rev Nutr Diet, Basel, Karger 1993; 72: 49-60.
Mordoy A Is there a rational use for n-3 fatty aciels (fish oils) in clinicai medicine? Drugs 1991; 42 (3): 331-342.
Davidson MH, Bums JH, Subbaiah PV, Conn ME, Drennan KB Marine il capsule therapy for the tratment of hyperlipielemia Arch lntern Med 1991: 151: 1732-1740.
Leaf A, Weber PC Cardiovascular effects of n-3 fatty acids. N Engl J Meel 1988: 318: 549-557
Willumscn K, Hexeberg S, Skorve J, Lundquist M, Berge RK Do cosahexaenoic acid shows no triglyceride-lowering effects but increases the peroxisomal fatty acid oxidation in liver of rats. J Lipid Res 1993: 34: 13-22.
Otten W, Wirth C. Iaizzo PA, Eichinger HM. A high omega 3 fatty acid diet alters fatty acid composition of heart, liver, kidney, adipose tissue anel skeletal muscle in swine. Ann Nutr Metab 1993: 37 134-141.
Schmielt F.B n-3 polyunsaturatecl fatty aciels anel ischaemic heart disease. Curr Op Lipidol 1993: 4: 27-33
Harris WS. Muzio F. Fish oil recluces postprandial triglyceride concentrations without accelerating lipidemulsion remova! rates. AmJ Clin Nutr 1993: 58: 68-74.
Harris WS. Connor WE. Alam N, Dlingworth DR. Reduction of rostprandial triglycceridemia in humans by elieta1y n-3 fatty acids J Lipid Res 1988; 29: 1451-1460.
Von Schacky C. Fishér S, Weber PC. Long terrn effects of clietary omega-3 fatty acids upon plasma and cellular lipiels, platelet function anel eicosanoiel formation in man. J Clin Invest 1985; 76: Hí26-1631.
Knapp HR. Reilly IAG, Alessandrini P, Fitzgerald GA. ln-vivo in dexes on platelet and vascular function during fish oil administration in patients with atherosclerosis. N Engl J Mecl 1986; 314:937-942
Fisher S, Weber PC. Prostaglanclin B is formed in-vivo in man after clieta1y eicosapentanoic acid. Nature 1984: 307: 165-168.
Scmidt EB, Pederson JO,Jersild C, Ditzel J, Grunnet N, Dyerberg J. The effect of n-3 polyunsaturated fatty acids on lipids, haemostasis, neutrophil and monocyte chemotaxis in insulin depen dent diabetes mellitus. J lntern Med (suppl) 1989; 225: 201-206.
Fox PL. DiCorleto PE. Fish oil inhibit endothelial cell production of platelet-derived growth factor-like protein. Science 1988; 241: 453-456.
Shimokawa H, Vanhoutte PM. Dietary cod-liver oil improves endothelium dependem responses in hypercholesterolemic anel atherosclerotic porcine coronary arteries. Circulation 1989; 78: 1421-1430
Fleishauer FJ, Lee TC, Wellesson U, Fischell TA. Fish oil improves enclothelium-dependent coronary vasodilation in cardiac transplant recipients. Circulation 1990: 82 (suppl III): III 468 (abstr.)
McVeigh GE, Brennan GM,Johnston GD, McDermott BJ, McGrath LT, Henry WR, Andrews JW, Hayes JR. Dietary fish oil augments nitric oxide production or release in patients with type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia 1993; 36: 33-38.
Mehta J, Lawson D, Saldeen T. Reduction in pasminogen activator inhibitor-1 (PAI-1) with omega-3 polyunsaturated fatty acids (PUFA) intake. Am HeartJ 1988; 116: 1201-1206.
Hostmark AT, Bjerkeclal T, Kierulf P, Flaten H, Ulshagen K. Fish oil and plasma fibrinogen Br Med J 1988: 297 180-181.
Raclack K, Deck C, Huster G. Dietary supplementation with low close fish-oil lowers fibrinogen leveis: a randomized, douhle blind controlled study. Ann Intern Med 1989; 111: 757-7-,8.
Prevention of coronary heart disease: scientific background and new clinical guidelines. Recommendations of the European Atherosclerosis Society prepared by lhe international task force for the prevention of coronary heart disease. Nutr Metab Cardiovasc Dis 1992; 2: 113-156.
Lorentz R, Spengler V, Fischer S, Duhn.J, Weber PC. Platelet function, thromboxane formation and blood. pressure control during supplementation of the Western diet with cod liver oil. Circulation 1983; 67: 504-511.
Engler MB, Engler MM, Ursell PC. Vasorelaxant properties of n-3 polyunsaturated fatty acids in aortas from spontaneously hypertensive and normotensive rats. J Cardiovascular Risk. 1994; 1(1 ): 75-80
Enrst E. Effects of n-3 fatty acids on bloodrheology. Journal of Internal Medicine 1989; 225 (suppl 1 ): 129-132.
B0naa KH, Bjerve KS, Straume B, Gram IT, Thelle D. Effect of eicosapentanaeoic anel elocosahexaenoic acids on blood pressure in hypertension: a population-based intervention triai from the Tromso Study. N Engl J Mecl 1990: 322: 79-,-801.
Moms MC, Sacks F, Rosner B. Does fish oil lower blood pressure1 A meta-analysis of controlled trials. Circulation 1993: 88: 523-533
Lofgren RP, Wilt 1], Nicho! KL, Crespin L, Pluhar R. Eckfeldl J. The effect of fish oil supplements on blood pressure. Am J Public Health 1993: 83: 267-269
Nozaki S, Kubo M, Takemura K, Matsuzawa Y, Tarui S. Effects of purified eicosapentaenoic acid ethyl ester (EPA) on lipoprotein composition. Circulation 1990; 82. (supll III): III 477 (abstr.)
Lorgeril M, Renaucl S, Mamelle N, Salen P, MartinJL, Monjaud I. Guiclollet J, Touboul P, Delayej. Mediterranean alpha-linole nic acid-rich diet in secondary prevention of coronary heart disease. Lancet 1994; 343; (8911): 1454-1459.
Hock CE, Holahan MA, Reibel DK. Effect of dietary fish oil on myocardial phospholipds and myocardial ischemic damage. Amj Physiol 1987; 252: 554-560.
Matsukura T, Miyagawa M, Satoh K, Mineo S, Yanagisawa A. lshikawa K. Effect of dietary fish oil on infaret size in feline myocardial ischemia. Circulation 1990; 82 (suppl III): III 39 (abstr.).
Dehmer GJ, PopmaJJ, Van Den Berg EK, Eichhom EJ, Prewilt JB, Campbell WB, Jennings L, Willerson JT, Schmitz JA. Reduction of the rate of early restenosis after coronary angioplasty by a diet supplemented with n-3 fatty acids. N Engl J Med 1988: 319: 733-740
Grigg LE, Kay TWH, Valentine PA, Larkings R, Flower DJ, Mano las EG, O'Dca K, Sinclair AJ, Hopper JL, Hunt D. Determinants of restenosis and lack o effect of dietary supplementation with eicosapentaenoic acid on the incidence of coronary artery restenosis after angioplasty. J Am Coll Cardiol 1989;13: 665-672.
Gapinski JP, VanRuiswyk JV, Heudebert GR, Schectman GS. Preventing restenosis with fish oils following coronary angioplas ty. A mela-analysis. Arch lntern Med 1993; 153: 1595-1601.
Burr ML, Fehily AM, Gilbert JF, Rogers S, Holliday RM, Sweet man PM, Elwood PC, Deadman NM. Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: die and reinfarction triai (DART). Lancet 1989; 2: 757-761.
Seidelin KN, Myrup B, Fischer-Hansen B. n-3 fatty acids in adipose tissue and coronary artery disease are inversely related. Am J Clin Nutr 1992; 55: 1117-1119.
Dolecek TA. Epidemiological evidence of relationships between dietary polyunsaturated fatty acids and mortality in the multiple risk factor intervention trial. Proc Soc Exp Biol Med, 1992; 200: 177-182.
Lorenz R. Q-3 fatty acid and risk of atherosclerosis. Em: Fish oi! and blood-vessel wall interactions, Eds. PM Vanhoutte, Ph Douste-Blazy.John Libbey Eurotext, Paris 1991; pp: 133-139.
Jensen T, Stender S, Goldstein K, Holmer G, Deckert T. Partial normalisation by dietary cod-liver oil of increased microvas cular albumin leakage in patients with insulin-dependent dia betes and albuminuria. N Engl J. Med 1989; 321: 1572-1577.
Berthezene F. Q-3 fatty acid and diabetes mellitus" Em: "Fish oil and blood-vessel wall interactions, Eds. PM Vanhoutte, Ph Douste-Blazy. -John Libbey Eurotext, Paris 1991; pp:129-131.
Kristensen SD, De Caterina R, Schmidt EB, Endres S. Fish oil and ischaemic heart disease. Br Med J 1993; 70: 212-214.
Suzukawa M, Abbey M, Nestel PJ Effect of fish oil fatty acids on LDL size, oxidizability and uptake by macrophages. Atherosclerosis 1994; 109: 73.
Goodnight SH, Fisher M, Fitzgerald GA, Levine P. Assessment of therapeutic use of dietary fish oil in atherosclerotic vascular disease and thrombosis. Chest 1989; 95 (suppl 2) 19S-25S.
Glauber H, Wallace P, Griver K, Bretchel G. Adverse metabolic effect of omega-3 fatty acids in non-insulin-dependent diabetes mellitus. Ann lntern Med 1988; 108: 663-668.
Svensson BG, Nilsson A, Hansson M, Rappe C, Akesson B, Skerfving S. Exposure to dioxins and dibenzofurans through the consumption offish. N Engl J Med 1991; 324: 8-12.
McKeigue P. Diets for secondary prevention of coronary heart disease: can linoleic acid substitue for oily fish. Lancet 1994; 343 (8911): 1445.
Ozerova IN, Shuvaeca TI, Kalinkina OM, Perova NV, Oganov RC. Long-term intake of fish-enriched diet in patients with coronary heart disease. Atherosclerosis 1994; 109: 72.
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